Vaginal Discharge

by Roman Lester Rosales, Pharmacist

Vaginal discharge produced by the vaginal and cervical glands is essential in maintaining a healthy female reproductive system.

The amount of discharge and other attributes (e.g. odour, consistency and colour) may vary throughout a women’s menstrual cycle, depending on the amount of oestrogen, a female hormone, circulating in the body.

Normal vaginal discharge

Usually, vaginal discharge that ranges from clear and watery to white and stick is considered normal. The amount may increase during ovulation period or when sexually aroused, and may smell different during pregnancy.

Even psychological stress is found to have an effect in the amount of vaginal secretions.

Abnormal vaginal discharge

When the vaginal discharge is significantly different, accompanied by unusual symptoms, it may be a sign of an underlying problem or infection. Changes in the vaginal flora balance may also affect the nature of the vaginal discharge.

Vaginal thrush or yeast infection is one of the common causes of abnormal vaginal discharge related to altered vaginal flora. The discharge is usually thick and white but odourless (often described as ‘cottage cheese-like’).

Any white, grey or yellowish discharge with a distinctive fishy odour may be an indication of bacterial vaginosis. Bacterial vaginosis occurs due to the overgrowth of one strain of bacteria among the vaginal flora leading to an infection.

Abnormal discharge may also be a symptom of sexually transmitted diseases (STD) such as gonorrhoea and trichomoniasis.

In a case of gonorrhoea, cloudy or yellow discharge with other symptoms, such as urinary incontinence and sometimes bleeding, will be present. Frothy, yellow or greenish discharge with foul odour accompanied by pain or itching while urinating may be a sign of trichomoniasis.

Most women undergoing menopause will have reduced oestrogen levels in the body, leading to decreased vaginal discharge. Abnormal vaginal bleeding, pelvic pain with bloody or brownish discharge may be a sign of irregular menstrual cycle and very rarely, cervical or endometrial cancer.

Other causes of abnormal vaginal discharge include pelvic inflammatory disease, vaginitis and genital warts.

Managing abnormal vaginal discharge

It is important to identify the cause of the abnormal discharge so that appropriate treatment may be recommended. If symptoms suggest vaginal thrush, over-the-counter and pharmacy oral medications, vaginal inserts or creams can be used to manage the symptoms.

When to consult a doctor

Abnormal vaginal discharge resulting from causes other than vaginal thrush should be referred to the doctor. Consult your doctor immediately if you experience any unusual vaginal bleeding, burning pain when urinating, and any presence of ulcers or blisters on the vagina or vulva.

If symptoms worsen or extend beyond one week with or without treatment, or are recurrent despite self-treatment, inform your doctor.

Prevention is better than cure

Proper feminine hygiene is important in preventing any abnormal vaginal discharge caused by vaginal infections. Here are some ways to ensure proper feminine hygiene:

• Keep the area clean using unscented soap or feminine wash regularly
• Avoid using coloured or scented sanitary pads, toilet tissues, bubble baths, feminine hygiene sprays and creams
• Vaginal douching is not recommended as it may remove the healthy bacteria lining the vagina and lead to uterine or fallopian tube infections
• When cleansing after urinating or a bowel movement, remember to wash and wipe in a front-to-back (vagina to anus) direction
• Keep the genital areas dry by changing out of wet clothing as soon as possible
• Wear cotton underwear and change them on a daily basis
• Use condoms during intercourse and sanitary pads instead of tampons during menstrual period
• Abstain from sexual intercourse when diagnosed with vaginal infections

Monitoring vaginal discharge is important and seeking treatment is advised when necessary. If self-care is not sufficient in managing abnormal vaginal discharge, do consult a healthcare professional.